JAMES GARBARINO: Thank you very much. I wanted to come back and do what is the first talk about this new book here, a book that is sort of being launched in the next month because much of the early work I did as an expert witness in murder cases was when I was here as a faculty member.
It began in 1994. And of course in a sense this is really my life's work, so it really begins in many ways in Ithaca when I came to graduate school at Cornell in 1970-- it's a long time. Actually, 1968 if the truth be told. So I thought it was very fitting and it was very important for me to launch this here among people in an institution that was very important intellectually to this work.
Now, for the past 20 years, as the title implies-- it's now 21 years or so-- I've been serving as an expert psychological witness in murder cases. At the time I was writing this book, the number was about 62. It's now more like 75. I don't know that there's a central registry for people who do this, but I think that may be more than anybody else has done. I'm not sure.
So what I wanted to do today and what I've done in more detail in this book is to represent what I think are some of the important thoughts and feelings and ideas that come out of this. Most people don't have murderers in their lives. I have a lot of murderers in my life.
They're in my head, they're in my heart. I'm in correspondence with some of them in prison. I'll be interviewing somebody on Monday in Harrisburg, another case.
What I've tried to do in those cases in the testimony and what I've tried to outline in this book is to sort of in a sense bring developmental psychology into the courtroom. Now, there are ways in which that has happened in the past. Our own Steve Ceci-- I call him our own Steve Ceci. Some of you may have seen an article he did with Maggie Bruck about 10 years ago called "Forensic Developmental Psychology."
The article and the work is about children as witnesses however, and that's not really what I'm talking about here directly. You see, when people are tried for murder, particularly if they're in a death penalty state-- of which there are about 33 and then there's the federal government as well-- usually there are two stages to the trial.
There's the guilt or innocence phase and then they go to a penalty phase. And if it's a death penalty case, then there's a separate sort of hearing or trial often with the same jury who's done the guilt and innocence phase, sometimes with a judge, sometimes with a new jury. It varies from state to state.
But at that point in the process, there's an attempt to introduce what is called mitigation. And mitigation is a series of influences or facts that the defense believes will create at least some sympathy on a jury's part, maybe a little understanding, maybe even a tinge of compassion.
Most of the time when I testify it is in that phase, in the penalty phase. And the prosecution is presenting what they call exacerbating factors, things that from their point of view should make the jury even more willing to execute this person. But sometimes I testify in the guilt or innocence phase, where the question is often how do you understand why somebody did this in human terms.
So the overarching thing is understanding in human terms, trying to see how there's a human not a demonic explanation for what is often horrible stuff. You know, we're talking about people being shot. We're talking about people being stabbed 37 times. We're talking about children being beaten to death by boyfriends. The full range of horrible things that happen to human beings that result in their death.
Now, let me start with an example. This is a case that throughout the book there are-- all the cases are disguised and names changed and all the rest of it so I hope no one ever figures out exactly who people are. The people involved will probably figure it out.
There was a case not long ago where I sat with a guy. It was his third trial for the same murder. You know, often these cases get appealed, they get new trials. It goes on and on.
So imagine this is a guy-- he's in mid 30s at the time. This guy is so scary that even for the interview they won't take the shackles off. They usually take the shackles off and we sit across from each other.
But the prison thought he was so scary that they kept him shackled with the hands and his legs and a chain from his hands to a bolt in the floor. This is a guy who's so scary that when he appears in court they have six correction officers there in the court room because they're afraid he's going to blow up and explode.
He's killed at least one person while he's been in prison. He went to prison originally for killing a convenience clerk as part of a robbery. So this is a big, scary guy. And like a lot of guys in prison, you know, he's done the weightlifting so he's got the big, bulging muscles, he's got the tattoos. This is not somebody who you would feel comfortable encountering in almost any situation.
So we go through his history, the fact that he sort of started going to prison at 15. We delve into his childhood, his family, this horribly traumatic life that he led as a child. Most of this is in records and previous assessments and so on.
But the end of the interview I ask him a question that I often ask these guys. I said, is there something you could tell me about yourself that people would be surprised to hear. And this very scary man thought for a minute and he said, yeah, there's something. I cry myself to sleep every night.
And I mention in part because there was documentation for this going back to when he was in prison when he was 15. There had been a federal lawsuit against the juvenile justice system in the state that he was located. And I had a stack of depositions that were taken for that federal lawsuit, and one of them was from a guy who had been this guy's cellmate when he was 15. And in passing he remarks, you know, this guy I'm sharing a cell with, he cries himself to sleep every night.
I mention that because one of the themes throughout all of this is a good at least first approximation is that most of these killers are best understood as untreated traumatized children who inhabit and control the minds, hearts, and bodies of adult men, mostly men. And so we're going to sort of work back to that in a way. So in a sense what this work, the work I do now I see is very consistent with what I started with because it's really about how gross violations of the human rights of children ultimately so often lead to the most violent, inhumane actions by adults.
Now, in these cases there's usually a social history which is usually a collection of facts about their life. But what the social history lacks is any sort of usually sort of conceptual framework to make it a developmental analysis. It's a series of bad things and incidental things. In addition, there usually is a clinical assessment which is full of diagnoses.
Now, the litany of diagnostic labels that you often see in the records might look like it's an improvement over the social history because it is conceptual in a sense. But the problem that I really contend with is that most of these diagnostic labels have no developmental dimension to them and, in fact, if you unpack them, they're kind of simply labels for observations but they gain a sort of heightened status.
For example, there's a diagnosis of conduct disorder which is an official, DSM-5 diagnosis. But all it really means is that somebody has observed the chronic pattern of aggression, bad behavior, acting out, and violating the rights of others. The question is do you really know more from using that diagnostic label than you knew before? There are ways in which you may know less.
For example, here in New York state a number of years ago, the youth prison system issued a report from the research office that said based on our research, we find that 85% of the boys in prison have conduct disorder.
Well duh. Just how else would you get yourself in prison except by showing a chronic pattern of aggression, bad behavior, acting out, and violating the rights of others? It's a bit like if you did research on the football team at the Ithaca High School and reported that 85% of the players are athletes. I mean, wouldn't the interesting question be what are the other 15%?
And this goes on and on. There's a litany of diagnoses but they really don't tell you anything more than somebody has observed something. And, as I'll come back to later, it may be even worse than that. What I've tried to do is introduce what I call a developmental analysis to the social history that may incorporate some of the diagnostic assessments but hinges on applying developmental concepts to their life experience.
Now, if you want a metaphor for this, here's a metaphor. I'll give you a series of numbers. Those of you who are taking notes could write them down. 1, 3, 5, 7, 11, and 17.
Now, if you have no mathematical conceptual knowledge at all, that's just a list of numbers. If you have a sort of entry level mathematical knowledge, you say aha. Those are odd numbers, which they are.
However, once I tell you that the number 2 is on that list and the number 9 is not, if all you have is odd numbers, you're done. You're back to a bunch of numbers. You need a higher-order mathematical concept to make sense of that. How many of you know what it is? Yes.
SPEAKER 1: They're prime numbers.
JAMES GARBARINO: They're prime numbers, numbers divisible by 1 or by themselves. And now all of a sudden 2 is not an incongruity. It fits in the pattern. And furthermore, you can predict that what was missing in my list between 11 and 17 is 13.
That's a sense of what I'm trying to do in transforming the social histories into developmental analyzes, bring this conceptual knowledge to bear. Now, sometimes it's at a very, very, very primitive level.
For example, case of a young woman who was involved in a murder, 20-year-old. In the records was the fact that between the time when she was 9 and 12, she started dressing like a boy, refusing to bathe, being aggressive towards boys, and began engaging in erratic sexual behavior. And that's where they stopped.
What should be the hypothesis that you would explore for a girl who did that? Well, in the 21st century it ought to be that she was sexually abused.
Now, we're not-- if in the 1950s maybe not. You know, there's research in the 1950s published in the journal Child Welfare that concluded based on all the available evidence that the incidence of child sexual abuse was somewhere between one in a million and one in seven million in 1955.
Well, if we were doing this work in 1955, you might not expect to entertain that hypothesis about that girl. But now when most people if we polled you in this room would say one in 10, one in 20, one in four, that's the kind of hypothesis that ought to organize that information. And indeed that was the case in her case.
So some of this is very primitive in a sense. This is not the proverbial rocket science, although some of it does get more sophisticated. What I'm trying to do is bring this ecological perspective that John mentioned to bear on these social histories to make them developmentally coherent.
And to do that, there are a series of concepts that I think really particularly come into play. One of them is the accumulation of risk factors, which I think is one of the basic precepts of an ecological perspective. The idea that rarely if ever is there a single risk factor that accounts for much.
Those of you who are on the center listserv will know there was a reference recently to a long-term study of the effects of child abuse by Harun Cole, who I think is the son of the original Harun Coles who did this, concluding that by itself child maltreatment was not associated particularly with long-term bad outcomes. It was only when it was in the context of poverty and other kinds of deprivation.
Now, that makes good ecological sense because from an ecological perspective if the question is does x cause y, you know, the spirit of Yuri hovering over us would say the answer is it depends. It depends on the context in which it's occurring. And there has been a lot of progress in understanding ways to represent that context.
Now, in a lot of these trials the prosecution will dismiss the social history and say, well, sure. Lots of people have, you know, bad childhoods. You know, why should we give special attention to that here?
Well, one way that we've begun to give special attention to it is something that is called the adverse childhood experience scale. Just by a show of hands, how many people are familiar with that? Just a few of you are. This has now become one of the centerpieces for the Centers for Disease Prevention and Control in understanding how to assess the experience of kids.
Why? Because the finding has been that the assessment of these 10 items or these 10 influences in the first 18 years of life are very powerfully predictive of later health outcomes, morbid obesity being one, as well as heart disease. But for our more psychological interest, the finding is that score from zero to 10 accounts for something like 40% of the variation in adult depression, 65% of the variation in suicidal ideation and behavior, 56% of the variation in substance abuse. So this is a pretty powerful thing to know.
Now, there are 10 items. You know, I could read them to you if you want. But they deal with psychological maltreatment, physical abuse, sexual abuse, feelings of rejection, poverty and deprivation, parental divorce or separation, domestic violence between parents or parent figures, substance abuse in a parent, mental illness in a parent, and at least having one household member who went to prison.
Now, about 35% of Americans score zero on this scale. Lucky them or lucky you. Only about 2% of Americans have scores of five or more. Only about 0.001%, one in 1,000 people, have scores of 9 and 10.
This past summer I did three interviews in a row the client had a score of 10. And sort of almost rhetorically, this is very useful because if you go into court and the prosecution says, well, you know, lots of people have bad childhoods, say, yeah. But this guy had a worse childhood than 999 out of 1,000 people, and the kinds of adversity he experienced are so highly predictive of all kinds of dysfunction and problem adulthood.
A number of years ago I was testifying and the prosecutor after going through this said, well, he said, Dr. Garbarino, what about resilience? Why isn't this boy resilient?
And I was sort of taken aback because resilience typically is offered as a positive affirmation of human overcoming of adversity rather than a sort of deficit model. And I sort of had this idea that it wouldn't be long before there'll be a new diagnostic label.
Maybe in DSM-6 there'll be a diagnosis of RDD which is Resilience Deficiency Disorder and then some kids will have that in addition to their other diagnoses and then we can add yet another diagnosis of EAS, which is Excessive Alphabet Syndrome. If you have OCD and you have CD and you have RDD.
But the basic human issue is when this accumulation of risk reaches this level, it's not an individual deficit or deficiency that we're talking about. We're talking about overwhelming the human capacity to manage. The question is often how do these guys get up in the morning, and we know some of them cry themselves to sleep at night.
This process of diagnosis is a very interesting one in this kind of situation because often there is some recognition that trauma has played a role in the child's life. And the conventional rendering of trauma, even in the diagnostic material that appears often in these records, is of course the proverbial post-traumatic stress disorder.
If you know anything about trauma, you know that there has been a sort of-- there's been an effort to go beyond a simplistic rendering of trauma that way. Trauma as the combination of overwhelming arousal coupled with overwhelming cognition. That the body is overwhelmed and the mind is overwhelmed by what is happening.
I think one of the major advances in understanding this has come from a couple of researchers in Florida, Barbara Solomon and Kathleen Hyde, who have said what you really need to understand is there's at least three kinds of trauma. There's type 1 trauma which is one bad day. That's the kind that most people in this room would ever experience. That's if you live in the southern part of Manhattan on September 11th and the plane crashes into the building near your school.
One bad day. As you may know, the prognosis for recovery from that is pretty darn good. Come back in a year and 85%, 90% of those people are basically as OK as they were before.
Then there's type 2 trauma, which is repeated trauma. Some people call it complex trauma. And that's where you have more than one traumatic experience. That's pretty bad because it makes it harder to just say it was a bad day. It's sort of a bad life.
But Solomon and Hyde have talked about something they call type 3 trauma which is in early childhood, repeated violent trauma, usually of the worst kind. And I mention it here because when they look at the results of these three kinds of traumatic experiences, they find something which is of devastating importance in understanding these killers.
For type 1 trauma, they report that typically what you see is, one, a full, detailed memory of the traumatic event and two, you see conventional PTSD symptoms. Fair enough.
For type 2 trauma, which is multiple instances of trauma, you see-- for the most part, you can see that memory again, although it's not as clear. You see the PTSD. You see poor self-esteem and self-concept. You see feelings of shame. You see dependency. So you see those additional things in addition to the post-traumatic stress. Bad enough.
But for type 3 trauma, this attack on the fundamental process of child development in the early years of life, you see the PTSD symptoms, but then you see denial, repression, emotional numbing, poor self-esteem and self-concept, interpersonal distrust, superficial relationships, high anxiety, chronic depression, suicidality, feelings of shame, foreshortened sense of the future, rage, affective dysregulation, self injury, eating disturbance, narcissism, impulsivity, identity confusion, and dissociative symptoms. 23 in all.
What you don't see, the one thing that the other two forms of trauma produce that you don't see with this is full, detailed memory. And maybe you can grasp the irony that one reason why these killers typically are not seen, have not been seen as trauma victims is that they can't provide a detailed memory, narrative account, of their traumatic experience.
So ironically they're not typically seen as candidates for trauma-related services or compassion, and yet they have so many outcomes which can be diagnosed. It's almost like the old parable about when you have eight blind men and you ask them to tell what an elephant is like. You know, and one of them grabs the tail and says this is a rope and somebody grabs the leg and says this is a tree trunk and somebody grabs the ear and thinks this is a leaf and somebody grabs the side, thinks it's a wall.
I interviewed a guy not long ago, one guy. In his records were these diagnoses-- personality disorder, antisocial and schizoid type, major depression, dissociative disorder, anti-social personality disorder, borderline personality disorder, sociopathic behavior profile, PTSD, impulsive disorder, suicidal behavior and ideation, possible pedophilia.
What was happening was this guy had been so badly damaged in the early years of life that he was exhibiting all the things that Solomon and Hyde said he would expect, but each assessment came along and grabbed one little piece of it and it led to a diagnosis.
It wasn't exactly in this case, but another case-- and I hope you'll excuse this language I'm about to use. I was there at a day when a child psychiatrist was interviewing somebody about this case.
And we went into the lawyer's office and the lawyer said to the psychiatrist, now, what's your professional opinion of this person? And the psychiatrist said, he's fucking crazy. This guy is fucking crazy.
And why wouldn't he be if you look at his early destructive experience? To say that his problem is a deficit of resilience is insulting to his very humanity.
So when we start introducing these developmentally relevant perspectives, the adverse childhood experience, of course we also want to look at their developmental assets. Some of you-- how many of you know the Research Institute Developmental Assets? A few of you do.
And it's 40 positive things in a person's life. The more you have, the better off you are. With respect to violence, for example, if you got 31 to 40 of these assets, only 6% are engaged in violent behavior as teenagers. If you got zero to 10 of these assets, 61% engage in violent behaviors.
There are similar although not as strong patterns for substance abuse and early onset of sexual behavior. And on the positive side, the more assets, school success, delayed gratification, all this good stuff. There's usually an effort made-- I usually make an effort to find out about their developmental assets as well. But not surprisingly there usually aren't very many.
So all of this comes together to lead to, among other things, conceptualizing what these killers are about in terms of three issues, if you will. One of them is the choices they made.
The criminal justice system runs on choice. That's basically, I think, its primary energy. This person makes good choices, that person makes bad choices. It's predicated on a sense of choice as a matter of free will. It's predicated on choice as something that is done freely.
There's a whole chapter in this book about the concept of choice in the criminal justice system, which the more you get into it becomes so contextually driven that issues of trauma affect decision making, emotional damage affects decision making, context affects decision making. How many of us would make a good choice if we were incarcerated and had to choose between being the sexual slave of a more powerful individual or perhaps dying by refusing to do that? What exactly is the good choice?
Most killers have a history of prior incarceration. They have had to deal with these issues and whatever problems they have with executive functioning, which are often quite significant, and emotional regulation. Part of the problem is they have had to make choices which often have very serious consequences that most people never have to make. And that, I think, is a basis for showing compassion for them.
The second thing is this idea of the moral damage that they've experienced. Moral damage in the sense of the way they've come to understand their role in the world, the way they've come to understand the role of aggression in human experience.
I have a little-- I have only I think only have one chart in this book. It's a chart to explain what is called the war zone mentality.
And it's a chart that has one dimension is perception of threat. At one end is, you know, extremely hyper sensitivity to threat. You know, in a sort of psychological, psychiatric term, you have paranoids who see threat when there really isn't any. At the other end is an obliviousness to threat. I don't know that we have a diagnosis for that, but if we did it would probably be polyandry disorder.
The other dimension is legitimization of aggression. At one end is the pacifist who says there is no legitimization of aggression. At the other end is the psychopath who says there's unlimited legitimisation for aggression. I don't like the way you looked at me. I'm perfectly justified in killing you. I want your jacket. If you keep it from me, I'm perfectly morally justified in killing you to take your jacket.
The biggest concern is that the life experience of significant numbers of mostly guys but maybe an increasing number of women pushes them to what in effect is the northwest corner of that grid-- high sensitivity to threat and high levels of legitimisation of aggression. And when you look at their life histories, you see validation for the moral dimension of this in their parenting, in their neighborhood experience. That they are validated for aggression in their families, in their neighborhoods, in their schools, in their gangs, and then their experience of victimization pushes them to high levels of sensitivity to threat.
It's a very, very dangerous combination, this high sensitivity to threat and high legitimisation of aggression because it is like a war zone mentality in the sense that many soldiers can relate to. That if you're walking down a street in Fallujah in Iraq at the height of the battles, you take on a very different cognitive map of the environment that you see.
Now, [INAUDIBLE] used to talk about this in relation to World War I, writings about World War I as well. That you see the world in a different way when you're in a battlefield.
How many of you've see American Sniper? Probably some of you have. Well, you have a flavor of that a bit, what it's like to be in a war zone.
But these are basically in domestic war zones in the sense that when they walk out the door, they are in this war zone. And it generates this war zone mentality which explains why they shoot people preemptively, why they shoot people out of honor, or they shoot people to protect themselves and their loved ones-- things that many of us would do if we lived in that environment even without the same sort of socialization to it.
So there are those concepts. There's the concept of dissociation.
Now, Bruce Perry, some of you will know, has worked a lot on even an evolutionary view of the idea that children are particularly prone to respond to trauma with dissociation. You hear a lot about fight or flight which, as Perry argues, is basically an adult male model. Now, maybe in the 21st century, women can get in on the fight or flight thing too.
But his evolutionary analysis is that in the prehistoric days when human evolution was really raging that children had one basic strategy for dealing with threat and that was dissociative behavior. That if they fight back, they will be killed. If they run away, they will die.
It is only by dissociating that they will survive. And this trait, if you will, has become part of the human psyche and is observed very, very often in these children when faced with chronically traumatic environments at home and in the neighborhood.
Now, some of you know there was a time when multiple personality disorder was a big thing in this way of Freudian psychology and then it went out for a long time. It was thought to be a myth. But it's come back with modern neuroscience because it's come back as an explanation for the long-term, ultimate effects of extreme dissociation.
That one of-- the kid I was talking about before who had the 10 different diagnoses, his sister has full-blown multiple personality disorder. She's further on this continuum of dissociation than he is. He's got his own dissociative issues, but she's completely out there. And it is how she survived the family they lived in just the way Perry says they would have survived 50,000 years ago if their clan was attacked by a marauding band of invaders.
So dissociation is important in understanding why they so often are described as being emotionless, without remorse, that they're not affected by what they've done. They're often holding together through childhood from what has happened to them and this dissociative response becomes a habit of mind and spirit and heart and nervous system and brain.
And so now as a teenager, young adult, they're often punished for that because a jury looks at them in the chair and thinks what a cold, stone cold killer this is, when in fact what they're looking at is an untreated traumatized child whose dissociation is how he survived and now it comes back to haunt him.
Another concept of course, since we're talking about development, is the role of attachment in all of these relationships. We know attachment is one of the fundamental agenda items in child development certainly in the first year or two of life. What happens when that attachment does not succeed, when it does not proceed in a positive, effective way?
Well, come join me in some of these interviews and you'll begin to see some of that. You'll begin to see what disturbed attachment relationships, how they begin to have ramifications, how they begin to have echoes that go through other relationships.
Now, one of the things that's been observed is another Cornell connection, Geraldine Downey. Some of you know her work on what is called rejection sensitivity, the idea that one path that people who have early attachment issues may take is to develop a hypersensitivity to rejection.
Now, everybody has some sensitivity to rejection. Indeed, parental rejection is one of these central concepts. The work of Ronald Rohner, for example, looking at 118 countries around the world has found that in every culture, children who experience parental rejection turn out badly.
In their research, parental rejection accounts for 25% of the variation in bad outcomes, allowing that cultures define bad outcomes differently and even what it means to how you reject people. But the core experience of rejection is so universally destructive that it's almost one of the few things that an ecological perspective doesn't depend. It's bad.
But Geraldine studied this particular pathway of rejection sensitivity. Rejection sensitivity essentially is that you're so hypersensitive to being rejected that any behavior in any relationship that in your mind intimates, predicts, threatens, alerts, warns you of rejection is overwhelming.
Now, James Gilligan-- some of you know the work of Carol Gilligan on feminist development. This is James Gilligan, her husband, a psychiatrist work forensically.
He has this whole analysis about the role of shame in violence which is very persuasive. That when people are subject to profound shame, what they really fear is psychic annihilation, that they will cease to exist. And this of course, the prospect of psychic annihilation, is so overwhelming that it produces extreme reactions-- some suicidal, some homicidal.
There was a case I worked on a while ago where this guy one day took out his weapons and massacred his family. He killed his wife, he killed his two stepchildren.
Now, he had helped raise these children from infants, he adored these children. His life revolved around these children. This woman who had married him, you know, he was so grateful that she had married him because he knew he was such a loser.
He murdered them all, barricaded himself in his house. When the SWAT team came, fired at the SWAT team.
But he was so overwhelmed by this experience that he experienced full-blown dissociative amnesia. Every clinician who assessed him tried to trick him. They all concluded he really did not remember doing this.
He didn't believe he would be convicted because he thought eventually they would find the guy who broke into the house, knocked him out, and killed his family. He was absolutely certain of this. There was no malingering, there was no faking. This is really what he believed.
But sort of as a side point, one of the things that's essential in doing this kind of work is forming, at least in a situational way, empathic relationships with people who horrify you. So how to form an empathic relationship with this guy?
What I said to him when I went into the room was-- I'll call him Bill. I said, Bill, I want to start by saying how sorry I am for your loss, because from his perspective that's what it was. Somebody killed his family.
And, you know, he teared up. He said, man, nobody ever said that to me before because everybody just responded with the rage that's quite appropriate to what he did.
Eventually what it turned out was this is really a case that Geraldine Downey's research would really help explain. This is a guy who had marginalized and ambivalent relationships-- all the stuff that Geraldine talks about as the developmental origins of rejection sensitivity-- boy, and he had it full blown.
Because in the weeks preceding when he obliterated his family, his wife told him that she was probably going to file for divorce. His stepdaughter started talking back to him and telling him that, you know, she was on her own now. She didn't need him. And his son reconnected with his biological father.
So this guy was facing the end of all of his primary family relationships all at once. And given his state of rejection sensitivity, he responded, as Geraldine says, men often do-- with aggression, preemptive aggression. It was so extreme because the rejection was so extreme, the threat of psychic annihilation was so extreme that it pushed him to this state.
So that's a concept. Rejection, rejection sensitivity, that come up over and over and over again in understanding these lives.
Another one that comes up is something John mentioned, social toxicity. The idea that the social environment can be culturally and socially poisonous in the same way the physical environment can, and that vulnerable individual soak this up and it has effect on the way they relate to the world.
Now, some of these dimensions of social toxicity are pretty obvious. The gun culture, for example.
Now, I've interviewed guys who've killed people by stabbing them, just recently a guy who killed somebody with 37 stab wounds. It's a big deal to stab somebody to death. It requires sustained emotional focus to keep stabbing somebody.
You just try-- your hand will wear out trying to stab 37 times. It requires a rage. It requires a level of intensity. And the guys who have stabbed people to death, there's an explanation for why they've had that.
But shooting people to death is a casual, low investment behavior. And it is so clear that the toxicity of the gun culture that all of us live in, what these individuals particularly are vulnerable to is what elevates the body count.
You know, if the United States' murder rate-- if you took out all the gun homicides looks pretty much like other countries. It's the enabling of aggression becoming lethal through the presence of guns that does it. And there's a whole chapter in the book on the gun culture.
I might also point out that just looking at murder in a way is also unrepresentative. The FBI had a report out a few years ago that showed that if medical trauma technology today were at the same level that it was in the 1930s, the murder rate today would be eight times higher than it is. You think of murder as being a cold, hard fact, but it is contextual as well.
Guatemala, which has a terrible murder rate, has the same rate the US would have if we had the medical health care system that Guatemala has. Honduras, the same thing. So when you think about context of murder remember that lethal assault is a contextual variable and one of the countervailing forces against the social toxicity of the gun culture is the relative sophistication of the medical trauma technology culture. How sad that that's what we have to rely on but it's true.
A second common dimension of social toxicity is the shallow materialism of American life. The message that all of us are exposed to that your value is determined by what you have, what you buy, what you wear is bad enough if you're an affluent Cornell College student.
But one case I worked on, a 19 year old kid who didn't get the death penalty got life in prison. The first words out of his mouth were, I'm going to kill myself. And when asked why, he said, because I'm never going to the mall again. I'm never going to the mall again. That being cut off from that dimension of his experience, his American experience, made life meaningless.
Now, you can hope that eventually he sort of came to see things in a bigger, better way, and indeed a lot of these guys do. You know, if you go to prison for a long time, whether it's life in prison or not, you basically have a choice to make. Are you going to live as a savage barbarian or are you going to live as a monk?
And there are some amazing monks in American prisons. If you want to read about one, there's a guy named Jarvis Masters serving life sentence in California who has written a book called Finding Freedom. And he actually is the first officially ordained Tibetan Buddhist monk in American prison. He's living like a monk and he says he is freer than he was when he was on the streets and it's said so much it's true.
But of course the most important element of social toxicity that is implicated in killing is race, racism, and the legacy and the current reality of racism. The African American young men have a murder rate that is about eight times higher than Caucasian young men. And many people have written about what is called the cradle to school to prison pipeline for African American young men.
Why does race and racism play such a role in all of this? It's one of the least comfortable things to talk about for people, but it is literally the black elephant in the room in these issues.
Why is it there? Well, some of it is there because of what is called the Southern culture of honor. There's a book called All God's Children by Fox Butterfield that cites a lot of historical evidence on how the old South developed a particular variant on the culture of honor.
You know, the old South has had homicide rates higher than the rest of the country since before there was a country. Now, with the sort of homogenization of the culture, the fact that you can get Starbucks in Mississippi, this has modified a bit. But these differences used to be really big, on the order of a factor of 10 southern states to northern states.
And what Butterfield does is looking at the historical reference to show that it's because in the old South, they grew up this culture of honor. The culture that says if somebody disrespects you or dishonors you, that is such a threat of psychic annihilation that you are morally and psychically obligated to respond with aggression to restore your sense of personal integrity.
This is why dueling was so prevalent. This is why John Calhoun, senator from South Carolina, Vice President, wrote it in his autobiography that his mother told him that as a Southern male if he went out in the community and somebody disrespected him, she said there's only two acceptable outcomes-- you kill that person or they bring your body home. Anything else, she said, I would disown you as my son.
There's more current research, laboratory research. You have Northern males and Southern males, white. You walk down a hallway, somebody bumps into and verbally insults you.
And they look at the comments that they-- the questionnaires they fill out about what you would do in that situation. They measure the level of physiological arousal in their body to the insults. And Southern young men get more aroused than Northern young men.
The reason why it's so relevant here is that predominantly the African American population in the United States has its historical and cultural roots in the old South. That's one reason.
Related reason is the psychological concept of functional autonomy. Functional autonomy is a behavior which originally is under the control of reinforcement but develops enough intrinsic motivation and momentum that it continues even without the reinforcing conditions. That's a concept particularly dear to me since on my first comprehensive exam for my PhD at Cornell, I did not know what that was. And I've remedied that now 40-something years later.
But that's another thing, that this concept has developed functional autonomy within the African American community. Now, by itself it does not lead to preemptive aggression. What it leads to is reactive aggression.
It is the combination of the Southern culture of honor with the reality of racism that makes it so devastating because who is more likely to experience these experiences of disrespect than young African American males particularly? And carrying that Southern culture of honor with the exposure to racism is incredibly dangerous.
And if you read the book, you will see account after account of young men articulating that and how it was taught to them. How it was part of the socialization process in their homes, in their neighborhoods, in their churches, in their communities. It's a very, very powerful and insidious kind of force.
So all of those, I think, are dimensions of social toxicity that play a role in understanding these lives. There are these neighborhood structural things.
All right, so a kid by age 10 has developed a chronic pattern of aggression, bad behavior, acting out, and violating the rights of others. All right, we'll diagnose him with conduct disorder. What are the odds that that 10-year-old by the time they are 18 will have become a seriously violent delinquent?
Well, because we're at Cornell you know the answer is, it depends. It depends in part on the neighborhood they're growing up in. In some neighborhoods, only 15% of those 10-year-olds with conduct disorder develop into serious violent delinquents. In other neighborhoods, it's 60%.
So by a factor of four, where you are as a 10-year-old with a chronic pattern of aggression, bad behavior, acting out, and violating the rights of others predicts where you will end up as a teenager. And many of these killers have gone that route. Their family produces the conduct disorder, their neighborhood transforms it into violent delinquency. Had they lived somewhere else, they wouldn't have gone down that path.
So this is, you know, what we're trying to understand is how these children become these teenagers and these young men and, to some degree, young women. Now, Robert Zagar-- he's a friend of mine-- has done this amazing actuarial research on predicting which kids will end up as really violent individuals.
Now, if you know anything about the statistical problems with screening, you know that typically there's a reciprocal relationship between identifying people who will and false identifying people who won't but you think they will. Zagar has done better than anybody in history. He has gotten 97% precision identifying which kids will become violent and 97% in identifying which kids won't become violent.
He also developed an intervention, was implemented in Chicago. A recent article in Science by Sara Heller reports the results of this. By targeting kids who score high in the predictive and enrolling them in a jobs program, an anger management program, and a mentoring program, they reduce the number of killings by 43%. And then a new administration came in, said we can't afford those programs, they stop the programs, and that's why you were reading about the upsurge in murders in Chicago.
So there's an amazingly accessible route to blunting some of these effects. And if you read the book and read about Zagar's work, you'll see anger management because it deals with issues of emotional regulation and executive function, jobs because it deals both with resources and time allocation and validation for pro-social behavior, and mentoring because for some of them in the first time in their lives they get a coherent attachment relationship with somebody who is competent and caring and it can be transformative. So that's something that's very important to understand.
The last point, because I know I said wanted to stop at one. All right, so these are untreated traumatized children inhabiting the bodies of big men. But I said these are inhabiting the bodies of scary men.
And why are they so scary if they're inhabited by untreated traumatized children? Because little children are scary.
Consider the work of Richard Tremblay, a French-Canadian psychologist who found that the most aggressive period in the normal human life span is not adolescence, it is early childhood. That at 16 months of age, about 90% of toddlers are observed to engage in kicking, biting, punching, hitting, and so on. But this is largely inept because of their weakness.
Tremblay said imagine what would happen in North America if tonight when every toddler went to bed when he woke up tomorrow morning he was 6 foot 5 and weighed 220 pounds. Tremblay says the result would be by dinnertime tomorrow night many American parents would be dead, an even larger number would be maimed.
I routinely sit with those children inhabiting these big, scary bodies, and a lot of people are dead and a lot of people are maimed. Thank you. Thank you.
So this is, you know, sort of a brief tour which must conclude with have a nice day. Obviously, you know, if you want to follow up, you can read the book. I'd be glad to have you read the book. That's why I wrote it.
Two, you can email me. My email at Loyola is jgarbar, j-gar-bar, @luc.edu. Since I'm officially an emeritus professor at Cornell, I still have a Cornell which is jg38@cornell.
Or you can come over to BB Hall, right, if you want to chat some more. Or if you have a burning question and can't stay, we could take maybe a couple minutes for--
SPEAKER 2: Sure.
JAMES GARBARINO: --couple minutes for questions. Yes.
SPEAKER 3: Can you repeat your email?
JAMES GARBARINO: Jgarbar, j-gar-bar, @luc.edu, or if you're a go Big Red person, jg38@cornell--
SPEAKER 2: Luc what?
JAMES GARBARINO: Luc.edu, OK. But I check the Cornell one every day also and that's how I know about people being hit by buses and crime and college town and guest lecturers and things.
Are there other questions you want to ask right now before we-- all right. Well-- yes? In the back. A question?
SPEAKER 4: I just wondered-- I came in late so I'm not sure if you already addressed this. But in terms of successful therapy approaches for adults who didn't form those strong attachments as a young child, are you on the [INAUDIBLE] bandwagon as being a possibility to treat them? Or whatever sort of therapy approaches do you subscribe to to address specifically attachment issues?
JAMES GARBARINO: Well, there is some mention of that in the book, but I think this finding about, you know, with younger people, the role of mentoring when combined with anger management and jobs, you know, speaks to that forming an attachment relationship. You know, there are the trauma-related therapeutic interventions as I guess you're alluding to. Now, the basic problem is can you find a way to stabilize the arousal while you deal with the content of the thing?
The other thing I would say though is, you know, we have this PTSD which stands for post-traumatic stress disorder. I think it would go a lot further-- and there's people who have written about this-- to change what that D is from disorder to development. Call it post-traumatic stress development and now you see the possibility because, in fact, most people who have one incident of trauma, that's what they engage in is post-traumatic stress development.
I think-- what's her name-- Burston I think who wrote this article that said to call it a disorder is really disrespectful because it's people confronting the reality of human experience. That once you really know experientially that somebody could jump out at you in the night and beat the crap out of you and rape you, you don't have some delusion. You know something about that is real and other people haven't had to come to terms with that yet. So she says it's more respectful to think [INAUDIBLE] terms.
And once you do that, then I think too you can say, well, what is likely to promote the development of somebody whose trauma is tied up with these attachment relations? They may have a diagnosis of reactive attachment disorder and so on.
But I think some of it is finding ways-- I think maybe the best resource in a way would be the book The Brain That Changes Itself. Do you know that book? I mean, that is talking about the malleability of the adult brain and very nicely lends itself to if you involve people in other kinds of relationships and have enough control that they don't, you know, drift away from that, you could restructure their brains to work in a relationship.
Now, there are some people who are just so damaged I don't want to make any pretense. I mean, I've sat across from guys, a couple of serial killers, one of whom, you know, started his life in El Salvador and, you know, watched his grandfather be murdered. And then his mother came and got him and brought him to Los Angeles where he was in the MS-13 gang.
And it was a very sad-- and as lot of kids, was very sensitive kid. I don't know that anybody has anything powerful enough to correct the damage he experienced to make him safe to walk amongst us, as John said.
There are people who are congenitally have such difficulty with empathy that the best we can do is make them into corporate executives or politicians or something. As you know, the rate of psychopathy in executives and politicians is three times what it is in the general population. Certain kinds of cops, soldiers, lawyers, and even a few psychiatrists.
So there may be ways to structure it, but their fundamental lack of empathy makes it very, very difficult. If they grow up in antisocial environments rather than pro-social environments, that's really horrible.
Now, this study came out recently-- again, John put it out on the center listserv. It's a study by-- where is it? Blair and his colleagues, New England Journal of Medicine. When they looked at kids with conduct disorder found there were two types, lo and behold. There were the callous, unemotional ones, and the ones who their behavior was rooted in heightened threat sensitivity and reactive aggression.
So part of the diagnostic problem is these patterns may reflect very different developmental pathways. And even there, some of those callous, unemotional conduct disorder kids, some of them probably are better understood as kids whose environment was so traumatic that their dissociation would have to be so powerful to let them survive that that they become callous and unemotional. And I've certainly sat with guys like that. It's not that they were inevitably bound to be a psychopath.
Or another way-- another thing to-- have you ever watched Dexter, the TV series Dexter? Dexter is a great sort of resource in thinking about these issues because it has trauma, it has the healing power of relationship, it has the ability of pro-social socialization to guide even the sort of psychopathic person.
Dexter is over now. I watched the last episode on Netflix and it's a big hole in my life so I have to go visit his brother in prison now.
So I think there is enough evidence to sort of shake up the idea that these are fixed problems, these are inescapable traits. And that book by Doidge on The Brain That Changes Itself I think is one of the most positive, powerfully hopeful treatises on that because it has-- every chapter is a different problem that somebody thinks is intractable, somebody thinks is genetics, somebody thinks is irremediable, and he's got cited research to show that it's remediable. And if you're interested in psychoanalysis even the chapter on why psychoanalysis actually makes neuroscience sense, so that's kind of cool to have there too.
All right, other questions before we go? All right. Again, thank you very much. Thank you.

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James Garbarino of Loyola University describes his efforts to bridge the gap in legal proceedings between the 'social history' typically provided by social work and the 'diagnosis' provided by clinical psychology. Garbarino reflects on his twenty years of experience as a psychological expert witness in murder cases to highlight the humanity we share with killers and the role of understanding and empathy in breaking the cycle of violence. Recorded Feb. 19, 2015 as part of the BCTR Talks at Twelve series.